Profiles of the bacterial community in short-term indwelling urinary catheters by duration of catheterization and subsequent urinary tract infection.

BACKGROUND: Urinary catheterization, even of short duration, increases the risk of subsequent urinary tract infection (UTI). Whether the bacteria found on the surface of catheters placed for <3 days are associated with UTI risk is unknown. METHODS: We screened the biofilms found on the extraluminal surface of 127 catheters placed for <3 days in women undergoing elective gynecologic surgery, using targeted quantitative polymerase chain reaction and an untargeted 16S rRNA taxonomic screen. RESULTS: Using quantitative polymerase chain reaction, Enterococcus spp were found on virtually all catheters and lactic acid bacteria in most catheters regardless of duration, but neither genus was associated with UTI development during follow-up. Enterococcus, Streptococcus, and Staphylococcus were the most commonly identified genera in the taxonomic screen but were not associated with subsequent UTIs. Although the most common cause of UTI following catheter removal was Escherichia coli, detectable E coli on the catheter surface was not associated with subsequent UTIs. CONCLUSIONS: Our analysis does not suggest that the presence of bacteria on the surface of catheters placed for <3 days leads to subsequent UTIs. Other aspects of catheter care are likely more important than preventing bacterial colonization of the catheter surface for preventing UTIs following short-term catheter placement.

Primary teeth microhardness and lead (Pb) levels.

OBJECTIVES: Lead (Pb) exposure is associated with dental caries. Whether Pb affects tooth microhardness, is unclear. Our objective was to assess whether Pb concentration is associated with microhardness. METHODS: Exfoliated primary teeth were collected from 46 volunteers. Teeth were sectioned, one half of each tooth was tested for enamel Knoop microhardness. The remaining half was digested and Pb measured using an inductively coupled plasma-mass spectrometer. RESULTS: The correlations between Pb levels and microhardness were very low, and were not statistically significant at p < 0.05. CONCLUSIONS: Previous exposure to high levels of Pb was not associated with decreased tooth microhardness. CLINICAL SIGNIFICANCE: This study assessed whether Pb in deciduous teeth is associated with tooth microhardness. As this was not the case, further studies are needed to identify the mechanisms behind the association between lead exposure and tooth decay.

Association of Escherichia coli ST131 lineage with risk of urinary tract infection recurrence among young women.

OBJECTIVES: The aim of this study was to test the hypothesis that urinary tract infections (UTIs) caused by Escherichia coli of the sequence type 131 (ST131) lineage are more likely to recur than UTIs caused by other E. coli lineages. METHODS: Isolates from 221 young women with UTI caused by E. coli participating in a randomised controlled trial were used. Participants were followed for 6 months or until UTI recurrence. RESULTS: Sequence type was not associated with risk of recurrence. Isolates in the ST131 lineage were more resistant than other STs to quinolones (6.2% vs. 1.3%) but not trimethoprim/sulfamethoxazole (15.4% vs. 15.0%). CONCLUSIONS: These results do not support an increased risk of recurrent UTI among otherwise healthy women with UTI caused by E. coli ST131.

Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial.

OBJECTIVE: The risk of urinary tract infection (UTI) among women undergoing elective gynecological surgery during which a catheter is placed is high: 10-64% following catheter removal. We conducted the first randomized, double-blind, placebo-controlled trial of the therapeutic efficacy of cranberry juice capsules in preventing UTI after surgery. STUDY DESIGN: We recruited patients from a single hospital between August 2011 and January 2013. Eligible participants were undergoing elective gynecological surgery that did not involve a fistula repair or vaginal mesh removal. One hundred sixty patients were randomized and received 2 cranberry juice capsules 2 times a day, equivalent to 2 8 ounce servings of cranberry juice, for 6 weeks after surgery or matching placebo. The primary endpoint was the proportion of participants who experienced clinically diagnosed and treated UTI with or without positive urine culture. Kaplan-Meier plots and log rank tests compared the 2 treatment groups. RESULTS: The occurrence of UTI was significantly lower in the cranberry treatment group compared with the placebo group (15 of 80 [19%] vs 30 of 80 [38%]; odds ratio, 0.38; 95% confidence interval, 0.19-0.79; P = .008). After adjustment for known confounders, including the frequency of intermittent self-catheterization in the postoperative period, the protective effects of cranberry remained (odds ratio, 0.42; 95% confidence interval, 0.18-0.94). There were no treatment differences in the incidence of adverse events, including gastrointestinal upset (56% vs 61% for cranberry vs placebo). CONCLUSION: Among women undergoing elective benign gynecological surgery involving urinary catheterization, the use of cranberry extract capsules during the postoperative period reduced the rate of UTI by half.